Provider Demographics
NPI:1235306473
Name:ESTERLY-JAYNE, JILL A (LMSW)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:A
Last Name:ESTERLY-JAYNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S FRANCIS MINE DR
Mailing Address - Street 2:
Mailing Address - City:GWINN
Mailing Address - State:MI
Mailing Address - Zip Code:49841-9077
Mailing Address - Country:US
Mailing Address - Phone:906-228-3092
Mailing Address - Fax:906-273-1434
Practice Address - Street 1:104 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4318
Practice Address - Country:US
Practice Address - Phone:906-228-3092
Practice Address - Fax:906-273-1434
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010905541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical